决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Engineering strategies for broad application of TCR-T- and CAR-T-cell therapies.
Engineering strategies for broad application of TCR-T- and CAR-T-cell therapies.
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过继性细胞疗法,包括体外扩增后输注肿瘤浸润性 T 淋巴细胞,或通过抗原特异性转基因 T 细胞受体 T 细胞(TCR-T 细胞)或 CAR-T 细胞(CAR-T 细胞)将 T 细胞重定向至肿瘤抗原,已显示出显著的临床影响。
过继细胞治疗包括体外扩增后回输TIL(肿瘤浸润淋巴细胞),或回输经抗原特异性转基因T细胞受体重定向至肿瘤抗原的T细胞(TCR-T细胞),以及CAR-T 细胞(CAR-T 细胞),已显示出显著临床影响。尤其是,多种CAR-T 疗法已获批用于血液系统恶性肿瘤。CAR-T 疗法在血液系统恶性肿瘤中的突出成效,推动其进一步拓展至多种实体瘤;然而,缺乏具有肿瘤特异性表达模式的合适靶抗原,以及免疫抑制性肿瘤微环境(TME)削弱过继回输T细胞的效应功能等障碍,仍限制其临床应用。CRISPR/Cas9等基因工程技术使研究者能够灵活重编程TCR/CAR-T 细胞信号通路,或将针对肿瘤免疫抑制的基因作为载荷导入细胞,以克服这些困难。本文讨论TCR/CAR-T 细胞工程改造的最新进展。目前,多种有望增强过继回输T细胞在TME中抗肿瘤活性的策略正在临床试验中评估,旨在最大限度提高过继细胞治疗的疗效和安全性,尤其针对实体瘤。
Adoptive-cell therapy, including the transfer of tumor-infiltrating T lymphocytes after in vitro expansion or T cells redirected to tumor antigens using antigen-specific transgenic T-cell receptor T cells (TCR-T cells) or chimeric antigen receptor T cells (CAR-T cells), has shown a significant clinical impact. Particularly, several types of CAR-T-cell therapies have been approved for the treatment of hematological malignancies. The striking success of CAR-T-cell therapies in hematological malignancies motivates their further expansion to a wide range of solid tumors, yet multiple obstacles, including the lack of proper target antigens exhibiting a tumor-specific expression pattern and the immunosuppressive tumor microenvironment (TME) impairing the effector functions of adoptively transferred T cells, have prevented clinical application. Gene engineering technologies such as the CRISPR/Cas9 system have enabled flexible reprogramming of TCR/CAR-T-cell signaling or loading genes that are targets of the tumor immunosuppression as a payload to overcome the difficulties. Here, we discuss recent advances in TCR/CAR-T-cell engineering: various promising approaches to enhance the anti-tumor activity of adoptively transferred T cells in the TME for maximizing the efficacy and the safety of adoptive-cell therapy are now being tested in the clinic, especially targeting solid tumors.
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